Our client is seeking a Medicaid Professional who is responsible for transfer of MMIS management and operations knowledge and techniques to a Medicaid Program Standard Responsibilities: Provides guidance and direction for day to day operations and activities. Reviews MMIS issues and helps determine best solution for resolution. Develop procedures oriented to program integrity recoupment, requirements in managed care in alignment with the Code of Federal Regulations. Develop procedures on how to conduct contract monitoring and budgetary/expenditure reviews of contractors. Develop procedures on how to conduct annual audits and financial reviews of MCOs. Assist in developing guidelines to monitor Medicaid Program performance. Assist in training Medicaid Program staff to manage and operate key functional areas of the MMIS, i.e. Program Integrity, Surveillance Utilization Review, etc. Experience: 15 years of relevant experience that demonstrates progressive responsibility including 10 years of experience in a functional and/or Operational management role on an MMIS development or maintenance environment Consulting level experience with multiple business areas Able to excel in a face-paced environment with tight deadlines Excellent oral and written communication skills Required to be at on-site client location 4-5 days a week. 50% travel or must be willing to relocate. Desired Capabilities: Knowledge of Payment Error Rate Measurement and Medicaid Eligibility Quality Control Programs Familiarity with a Managed Care operating model Spanish language competency Knowledge of Medicaid Information Technology Architecture (MITA) principles and framework. Impeccable integrity. Candidates must be confident with their abilities to make correct decisions and the courage to speak out when necessary. Willingness and ability to effectively engage with people and organizations on a continuous basis. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call 888 472-3411 or email accommodationteksystems .com for other accommodation options.
